Expect a 10 percent increase this year, according to the consulting firm Segal. But that doesn’t mean you need to go broke paying for medicine. You can’t control the prices, but you can control–to some degree–how much you pay. Here’s how:
Know what your health plan covers: Often, what you pay for medication depends on your health plan.
Compare plans and formularies: Each year at open enrollment, carefully compare health plans and select one that covers medications you need at a reasonable cost. You want to look at the formulary — the list of drugs the plan covers. You need to do this every year, because plans change, and so do formularies.
Talk to your doctor: The best time to raise the issue of what a drug costs is before the prescription is written. Talk to your doctor about other options, including generics, which can be a fraction of the price of the name brand. If no generics are available, ask if there’s a less-costly medicine that will offer the same benefits. Most people don’t ask, and they often get sticker shock at the counter.
Check the formulary again: While you are in the physician’s office, check the formulary to confirm the medication being prescribed is covered by your plan and how much of its cost you’re expected to cover. (You can pull it up on your smartphone or bring a copy of your health coverage with you to the doctor’s office.)
Be a consumer: Patients are often passive. Consumers are active. Be a consumer. It’s your health and your money, after all.
Opt for the generic version: You already know this, but it bears repeating. And keep in mind–you may pay less for a generic you buy directly from the pharmacy than you would through your insurance company. That gets us to the next point…
Shop around: Don’t assume your insurance offers the best deal on prescription. Many stores, including giants Walmart and Costco, charge very little–sometimes nothing–for generic versions of certain drugs, such as antibiotics, and medicines for blood pressure, heart conditions and diabetes.
Ask for discounts: Shoppers who ask, “Is this your lowest possible price?” can get even further savings, according to Consumer Reports. Remember to ask about the cash discount before using your insurance.
Enlist your clinician as an advocate: Sometimes, your insurance company removes a drug from the formulary during the year. If this happens to you, you still may be covered. Ask your doctor to appeal to have the drug covered for you, at least for the rest of the year.
Consider coupons: Sites such as www.internetdrugcoupons.com offer manufacturer’s coupons. Your doctor’s office may have some, too. Keep in mind, however, that the discounts may only be temporary and the generic version may still be cheaper.
Tweak your buying habits: How you purchase your drugs can also cut your costs.
Stock up: Ask for a 90-day prescription instead of 30-day one. You may end up with only one copay. Do the same for refills.
Split it: If you are taking a tablet that comes in more than one dosage (e.g., 5mg and 10mg), you can sometimes order the larger dose and split the pill. Not all tablets work this way, so be sure to talk to your pharmacist and physician. Pharmacies can split the pills for you, or you can buy an inexpensive pill splitter at a drug store.
Use snail mail: You insurance company is probably pushing you in the direction of mail-order pharmacies. That’s because they can be cheaper. But remember to compare the costs.
Look for Medicare assistance programs: Sometimes, you need a little help covering prescription costs, especially if your medications are costly and unavailable in generic versions. There are various programs available, especially for those enrolled in Medicare.
Some pharmaceutical manufactures have special programs specifically for Medicare Part D. You can check your eligibility here.
Some states and territories offer similar assistance. Check here.
Review everything you take: Before your next physical, compile a complete list of all the medicines–prescription and otherwise–that you’re taking. The doctor, nurse or PA can review the list with you and identify medications you possibly don’t need. More important, they may see drugs that shouldn’t be taken together. This final step not only helps save money–it can save your life.
~ Health Scams Exposed